A prospective, randomised controlled multi-centre trial comparing in-hospital treatment and early assisted discharge for exacerbations of Chronic Obstructive Pulmonary Disease (COPD).

Exacerbations of Chronic Obstructive Pulmonary Disease cause many hospitalisations, leading to high health care expenses. Because of increasinng prevalence numbers the burden of COPD in the future will only increase.

There is a need for new treatmentmodels of which early assisted discharge is an example. Early assisted discharge schemes are not new, but have not been applied in the Dutch health care system. Also the cost-effectiveness of these schemes has not been proven yet.

In this randomised controlled trial patients that are hospitalised for an exacerabtion COPD are early assisted discharged on the fourth day. At home they receive care until the seventh day, from a nurse from the home care organisation. This nurse monitors the recovery of the patient, and if neccesary contacts the hopsital to consult the pulmonologist. At one month and 3 months after discharge from the program the patient visits the outpatient clinic for follow ups. At three month the study ends for the patient. Patients and their direct caregivers are asked to fill in questionnaires on time points day 1, day 3, day 7 and 3 months.

The trial is conducted in three hospitals, namely Catharina-ziekenhuis Eindhoven, Maxima Medisch Centrum Eindhoven/Veldhoven and Atrium Medisch Centrum Heerlen. In total 235 patients will be included. The cost-effectiveness part of the study will be perfomed by the IMTA institute of the ErasmusMC.

Early assisted discharge for exacerbations of Chronic Obstructive Pulmonary Disease (COPD) is an effective and cost-effective treatmentmodel in the Dutch health care system.

Day 1, 3 and 7 of treatment phase.

Follow up at 1 month and 3 months.

Intervention group will be early assisted discharged home on the fourth day of hospitalisation. They will receive the same medical treatment as the control group, but in their own environment.

The intervention group receives guidance of a nurse of the home care organisation until the seventh treatment day. The nurse not onlyl assists with daily activities, but also more disease related activities like breathing techniques or disease management.